Pineal yolk sac tumor: Difference between revisions

Jump to navigation Jump to search
 
(5 intermediate revisions by the same user not shown)
Line 6: Line 6:


==Overview==
==Overview==
*[[Pineal]] [[yolk sac]] [[tumor]] is a rare type of [[Extra-axial hematoma|extra gonadal yolk sac tumor]].
[[Pineal]] [[yolk sac]] [[tumor]] is a rare type of [[Extra-axial hematoma|extra gonadal yolk sac tumor]]. They make up a small fraction of all [[Intracranial abscess / granuloma|intracranial]] [[germ cell tumor]]s and an even small fraction of [[pineal]] masses overall.Pure [[Pineal body|pineal]] [[Endodermal sinus tumor|yolk sac tumors]] secrete [[AFP]].On microscopic [[histopathological]] analysis, [[Pineal yolk sac tumors|pineal yolk sac tumor]] is characterized by poorly differentiated [[Endothelial|endothelial-]][[Likelihood|like]], [[cuboidal]], or columnar cells with prominent nucleoli and significant mitotic activity.[[Pineal yolk sac tumors|Pineal yolk sac tumor]] is demonstrated by positivity to [[tumor markers]] such as [[AFP]], [[cytokeratin]], and [[Alpha 1-antitrypsin|AAT]].In upto 50% of cases, these tumors co-exist with other [[Germ cell tumor classification|germ cell tumors]]
* They make up a small fraction of all [[Intracranial abscess / granuloma|intracranial]] [[germ cell tumor]]s and an even small fraction of [[pineal]] masses overall.
[[Pineal yolk sac tumors|Pineal yolk sac tumor]] may be associated with [[Down syndrome]].Common [[Complication (medicine)|complication]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] includes [[obstructive hydrocephalus]].[[Prognosis]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] is generally poor.[[Symptoms]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] include [[headache]], [[nausea]], [[vomiting]], [[weakness]], [[confusion]], and [[somnolence]].Head [[CT scan]] and brain [[MRI]] may be helpful in the diagnosis of [[Pineal yolk sac tumors|pineal yolk sac tumor]].On head CT scan, [[Pineal yolk sac tumors|pineal yolk sac tumor]] is characterized by a [[Hypo-functioning thyroid|hypodense]], [[Hetero-oligomer|heterogenous]] mass in the [[Pineal gland|pineal]] region with signs of [[obstructive hydrocephalus]].On brain MRI, [[Pineal gland|pineal]] yolk sac tumor is characterized by [[Hypo-functioning thyroid|hypointensity]] on [[T1|T1-weighted images]] and [[Hyper IgM syndrome|hyperintensity on T2-weighted images]].There may be enhancement after contrast administration.[[Biopsy]] is generally done to confirm the [[diagnosis]] of [[pineal]] yolk sac tumor.
*Pure [[Pineal body|pineal]] [[Endodermal sinus tumor|yolk sac tumors]] secrete [[AFP]].
*On microscopic [[histopathological]] analysis, [[Pineal yolk sac tumors|pineal yolk sac tumor]] is characterized by poorly differentiated [[Endothelial|endothelial-]][[Likelihood|like]], [[cuboidal]], or columnar cells with prominent nucleoli and significant mitotic activity.
*[[Pineal yolk sac tumors|Pineal yolk sac tumor]] is demonstrated by positivity to [[tumor markers]] such as [[AFP]], [[cytokeratin]], and [[Alpha 1-antitrypsin|AAT]].
*In upto 50% of cases, these tumors co-exist with other [[Germ cell tumor classification|germ cell tumors]].
*''[[Pineal yolk sac tumors|Pineal yolk sac tumor]]'' may be associated with [[Down syndrome]].
*Common [[Complication (medicine)|complication]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] includes [[obstructive hydrocephalus]].
*[[Prognosis]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] is generally poor.
*[[Symptoms]] of [[Pineal yolk sac tumors|pineal yolk sac tumor]] include [[headache]], [[nausea]], [[vomiting]], [[weakness]], [[confusion]], and [[somnolence]].
*Head [[CT scan]] and brain [[MRI]] may be helpful in the diagnosis of [[Pineal yolk sac tumors|pineal yolk sac tumor]].
*On head CT scan, [[Pineal yolk sac tumors|pineal yolk sac tumor]] is characterized by a [[Hypo-functioning thyroid|hypodense]], [[Hetero-oligomer|heterogenous]] mass in the [[Pineal gland|pineal]] region with signs of [[obstructive hydrocephalus]].
*On brain MRI, [[Pineal gland|pineal]] yolk sac tumor is characterized by [[Hypo-functioning thyroid|hypointensity]] on [[T1|T1-weighted images]] and [[Hyper IgM syndrome|hyperintensity on T2-weighted images]].
*There may be enhancement after contrast administration.
*[[Biopsy]] is generally done to confirm the [[diagnosis]] of [[pineal]] yolk sac tumor.


==Historical Perspective==
==Historical Perspective==
Line 57: Line 44:
| colspan="2" |pineal glandular tissue
| colspan="2" |pineal glandular tissue
|-
|-
|[[pineocytoma]] (WHO grade 1) [[Pineal body|pineal paranchymal tomur]] of intermediate diffrentiation(WHO grade 2 or 3)
|[[pineocytoma]] (WHO grade ɪ ) [[Pineal body|pineal paranchymal tomur]] of intermediate diffrentiation(WHO grade ɪɪ or ɪɪɪ)
[[pineoblastoma]](WHO grade 4) [[Papilla|papillary tumor]] of pineal region
[[pineoblastoma]](WHO grade ɪv) [[Papilla|papillary tumor]] of pineal region
|
|
|
|
Line 131: Line 118:


==Differentiating Intracranial Germ cell Tumors from Other Diseases==
==Differentiating Intracranial Germ cell Tumors from Other Diseases==
*[[Intracrural fascia|Intracranial germcell tumors]] must be differentiated from other diseases that cause [[Compressive myelopathies|compressive]] [[syndrome]] ,rise of intracranial pressure , such as other brain tumors and every disease who can rise [[ICP]].<ref name="pmid23640020">{{cite journal| author=Fang AS, Meyers SP| title=Magnetic resonance imaging of pineal region tumours. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 3 | pages= 369-82 | pmid=23640020 | doi=10.1007/s13244-013-0248-6 | pmc=3675249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23640020  }} </ref>
*[[Intra-abdominal abscess|Intracranial germcell tumors]] must be differentiated from other diseases that cause [[Compressive myelopathies|compressive]] [[syndrome]] ,rise of [[intracranial pressure]] , such as other brain tumors and every disease who can rise [[ICP]].<ref name="pmid23640020">{{cite journal| author=Fang AS, Meyers SP| title=Magnetic resonance imaging of pineal region tumours. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 3 | pages= 369-82 | pmid=23640020 | doi=10.1007/s13244-013-0248-6 | pmc=3675249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23640020  }} </ref>
*[[Primary peritoneal cancer|Extra gonadal Germ cell tumors]] should be in differential diagnosis of [[Pineal body|pineal]] germ cell tumors.<ref name="pmid23559987">{{cite journal| author=Mufti ST, Jamal A| title=Primary intracranial germ cell tumors. | journal=Asian J Neurosurg | year= 2012 | volume= 7 | issue= 4 | pages= 197-202 | pmid=23559987 | doi=10.4103/1793-5482.106652 | pmc=3613642 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23559987  }} </ref>
*[[Primary peritoneal cancer|Extra gonadal Germ cell tumors]] should be in differential diagnosis of [[Pineal body|pineal]] [[Germ cell neoplasm|germ cell]] tumors.<ref name="pmid23559987">{{cite journal| author=Mufti ST, Jamal A| title=Primary intracranial germ cell tumors. | journal=Asian J Neurosurg | year= 2012 | volume= 7 | issue= 4 | pages= 197-202 | pmid=23559987 | doi=10.4103/1793-5482.106652 | pmc=3613642 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23559987  }} </ref>


==Epidemiology and Demographics==
==Epidemiology and Demographics==
Line 159: Line 146:
*In 54% of cases diagnosis is delayed because of non-specific symptoms.<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>
*In 54% of cases diagnosis is delayed because of non-specific symptoms.<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>


*The diagnosis of [[Cranial Electrobiological Stimulation|cranial germ cell tumors]] is based on the CT,MRI with gadolinium fundings and level of [[biomarkers]]([[HCG]],[[AFP]])of serum and csf.also [[histology]] need for diffrentiate type of GCTs.With normal biomarkers level ,for definitive diagnosis biopsy is requiered.<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>
*The diagnosis of [[Cranial Electrobiological Stimulation|cranial germ cell tumors]] is based on the CT,MRI with gadolinium fundings and level of [[biomarkers]]([[HCG]],[[AFP]])of serum and csf.also [[histology]] need for diffrentiate type of [[GCTs]].With normal [[Biomarkers of cardiac injury|biomarkers]] level ,for definitive diagnosis biopsy is requiered.<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>
*In addition we should determine [[Immunoblotting|Immuno]][[histo]]<nowiki/>chemichal markers for diagnosis([[c-kit]]/[[CD117]],oct3/4,PLAP).<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>
*In addition we should determine [[Immunoblotting|Immuno]][[histo]]<nowiki/>chemichal markers for diagnosis([[c-kit]]/[[CD117]],oct3/4,PLAP).<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref>


===History and Symptoms==
===History and Symptoms==


* The most common symptoms of [[Intracranial germ cell tumor|intracranial germ cell tumors]] include [[Parinaud syndrome|parinaud syn]] (because of hydrocephalus or commpresion of [[tectal]] plate ). Common symptoms of intercranial GCTs include DI(due to [[hydrocephalus]]), [[ataxia]] and [[dysmetria]] if affecting superior [[cerebellar]] peduncles, precocious puberty,headache ,nausea,[[Occipital|ocolomotor]] or [[Facial|facia]]<nowiki/>l [[paresis]],[[seizure]].<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref><ref name="pmid23640020">{{cite journal| author=Fang AS, Meyers SP| title=Magnetic resonance imaging of pineal region tumours. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 3 | pages= 369-82 | pmid=23640020 | doi=10.1007/s13244-013-0248-6 | pmc=3675249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23640020  }} </ref>
* The most common symptoms of [[Intracranial germ cell tumor|intracranial germ cell tumors]] include [[Parinaud syndrome|parinaud syn]] (because of hydrocephalus or commpresion of [[tectal]] plate ). Common symptoms of [[Intra-abdominal hypertension|intracranial]] GCTs include DI(due to [[hydrocephalus]]), [[ataxia]] and [[dysmetria]] if affecting superior [[cerebellar]] peduncles, precocious puberty,headache ,nausea,[[Occipital|ocolomotor]] or [[Facial|facia]]<nowiki/>l [[paresis]],[[seizure]].<ref name="pmid30271875">{{cite journal| author=Fetcko K, Dey M| title=Primary Central Nervous System Germ Cell Tumors: A Review and Update. | journal=Med Res Arch | year= 2018 | volume= 6 | issue= 3 | pages=  | pmid=30271875 | doi=10.18103/mra.v6i3.1719 | pmc=6157918 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30271875  }} </ref><ref name="pmid23640020">{{cite journal| author=Fang AS, Meyers SP| title=Magnetic resonance imaging of pineal region tumours. | journal=Insights Imaging | year= 2013 | volume= 4 | issue= 3 | pages= 369-82 | pmid=23640020 | doi=10.1007/s13244-013-0248-6 | pmc=3675249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23640020  }} </ref>




Line 182: Line 169:


===Echocardiography or Ultrasound===
===Echocardiography or Ultrasound===
*There are no [[Echocardiography for diagnosis of atrial fibrillation|echocardiography]]/[[ultrasound]]  findings associated with Pineal yolk sac tumors.
*There are no [[Echocardiography for diagnosis of atrial fibrillation|echocardiography]]/[[ultrasound]]  findings associated with [[Pineal body|Pineal]] yolk sac tumors.


===CT scan===
===CT scan===

Latest revision as of 19:38, 18 October 2019

WikiDoc Resources for Pineal yolk sac tumor

Articles

Most recent articles on Pineal yolk sac tumor

Most cited articles on Pineal yolk sac tumor

Review articles on Pineal yolk sac tumor

Articles on Pineal yolk sac tumor in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Pineal yolk sac tumor

Images of Pineal yolk sac tumor

Photos of Pineal yolk sac tumor

Podcasts & MP3s on Pineal yolk sac tumor

Videos on Pineal yolk sac tumor

Evidence Based Medicine

Cochrane Collaboration on Pineal yolk sac tumor

Bandolier on Pineal yolk sac tumor

TRIP on Pineal yolk sac tumor

Clinical Trials

Ongoing Trials on Pineal yolk sac tumor at Clinical Trials.gov

Trial results on Pineal yolk sac tumor

Clinical Trials on Pineal yolk sac tumor at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Pineal yolk sac tumor

NICE Guidance on Pineal yolk sac tumor

NHS PRODIGY Guidance

FDA on Pineal yolk sac tumor

CDC on Pineal yolk sac tumor

Books

Books on Pineal yolk sac tumor

News

Pineal yolk sac tumor in the news

Be alerted to news on Pineal yolk sac tumor

News trends on Pineal yolk sac tumor

Commentary

Blogs on Pineal yolk sac tumor

Definitions

Definitions of Pineal yolk sac tumor

Patient Resources / Community

Patient resources on Pineal yolk sac tumor

Discussion groups on Pineal yolk sac tumor

Patient Handouts on Pineal yolk sac tumor

Directions to Hospitals Treating Pineal yolk sac tumor

Risk calculators and risk factors for Pineal yolk sac tumor

Healthcare Provider Resources

Symptoms of Pineal yolk sac tumor

Causes & Risk Factors for Pineal yolk sac tumor

Diagnostic studies for Pineal yolk sac tumor

Treatment of Pineal yolk sac tumor

Continuing Medical Education (CME)

CME Programs on Pineal yolk sac tumor

International

Pineal yolk sac tumor en Espanol

Pineal yolk sac tumor en Francais

Business

Pineal yolk sac tumor in the Marketplace

Patents on Pineal yolk sac tumor

Experimental / Informatics

List of terms related to Pineal yolk sac tumor

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD[2]Sujit Routray, M.D. [3]

Synonyms and keywords: Pineal yolk sac tumors; Pineal yolk sac tumour; Pineal yolk sac tumours; Pineal endodermal sinus tumor; Pineal endodermal sinus tumors; Pineal endodermal sinus tumour; Pineal endodermal sinus tumours; Pineal yolk sac carcinoma; Pineal yolk sac carcinomas; Pineal gland tumor; Germ cell tumor; Brain tumor

Overview

Pineal yolk sac tumor is a rare type of extra gonadal yolk sac tumor. They make up a small fraction of all intracranial germ cell tumors and an even small fraction of pineal masses overall.Pure pineal yolk sac tumors secrete AFP.On microscopic histopathological analysis, pineal yolk sac tumor is characterized by poorly differentiated endothelial-like, cuboidal, or columnar cells with prominent nucleoli and significant mitotic activity.Pineal yolk sac tumor is demonstrated by positivity to tumor markers such as AFP, cytokeratin, and AAT.In upto 50% of cases, these tumors co-exist with other germ cell tumors Pineal yolk sac tumor may be associated with Down syndrome.Common complication of pineal yolk sac tumor includes obstructive hydrocephalus.Prognosis of pineal yolk sac tumor is generally poor.Symptoms of pineal yolk sac tumor include headache, nausea, vomiting, weakness, confusion, and somnolence.Head CT scan and brain MRI may be helpful in the diagnosis of pineal yolk sac tumor.On head CT scan, pineal yolk sac tumor is characterized by a hypodense, heterogenous mass in the pineal region with signs of obstructive hydrocephalus.On brain MRI, pineal yolk sac tumor is characterized by hypointensity on T1-weighted images and hyperintensity on T2-weighted images.There may be enhancement after contrast administration.Biopsy is generally done to confirm the diagnosis of pineal yolk sac tumor.

Historical Perspective

  • Tumors of brainstaim as well as pineal gland,were unoperable until late of 20th century.[1]
  • Dr Cushing reported one of the first case in 1904.[1]
  • Dr Horsley in 1905 was the first who did direct surgical intervention,and in 1913 Dr Oppenhein and Krause resected pineal tumor sucssesfully.[1]
  • There are only two case Reports of pineal yolk sac tumor that are associated with Down's syndrome in English literature.[2]

Classification

Adapted from WHO:

TUMOR FREQUENCY ORIGIN
GERMCELL TOMURS 60% Rest of germ cells
Germinoma MATURE TERATOMAMATURE TERATOMATERATOMA with Malignant Transformstion Yolk sac tomur

(endodermal sinus tumor) Embryonal carcinoma Choriocarcinoma

PINEAL PARANCHIMAL TUMORS 30% pineal glandular tissue
pineocytoma (WHO grade ɪ ) pineal paranchymal tomur of intermediate diffrentiation(WHO grade ɪɪ or ɪɪɪ)

pineoblastoma(WHO grade ɪv) papillary tumor of pineal region

TOMURS OF SUPPORTIVE AND ADJUCENT STRUCTURES 10%
ASTROCYTOMAGlioma (glioblastoma or oligodendroglioma)Medulloepithelioma Glial cells
Ependymomachoroid plexus papilloma Ependymal lining
MENINGIOMA Arachnoid cells
HemangiomaHemangiopericytoma or

blastomaChemodectomaCraniopharyngioma

vascular cells
NON-NEOPLASTIC TUMOR LIKE CONDITIONS < 1%
Arachnoid cysts Arachnoid cells
Degenerative cysts(pineal cysts) Glial cells
Cysticercosis parasites
Arteriovenous malformations vascularization
Cavernomas Aneurysms of the vein Galen
METASTASES <.,1% Absence of blood -

brain barrier

Lung (most common),breast,stomach,kidney,melanoma

Pathophysiology

Causes

Differentiating Intracranial Germ cell Tumors from Other Diseases

Epidemiology and Demographics

  • The incidence of pineal tumor is approximately [1%] of all intracranial tumors.[3]
  • The incidence of pineal tumor is 0,06 -0,07 per 100,000 persons per year.[3]
  • Patients of all age groups may develop pineal yolk sac tumor,But is more common in children(3-8%)and also in Japenes population.[3]
  • There is no racial predilection to pineal tumors.[3]
  • pineal tumors affect men more than women.[8]
  • The majority of pineal tumor cases are reported in Japenes population.[3]

Risk Factors

  • There are no established risk factors for pineal yolk sac tumor.

Screening

  • There is insufficient evidence to recommend routine screening for pineal yolk sac tumors.

=Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Study of Choice

  • In 54% of cases diagnosis is delayed because of non-specific symptoms.[9]

=History and Symptoms


Physical Examination

facial nerve parasia.[6]

Laboratory Findings

Electrocardiogram

X-ray

  • There are no x-ray findings associated with pineal yolk sac tumors.

Echocardiography or Ultrasound

CT scan

.

=MRI

Other Imaging Findings

  • There are no other imaging findings associated with cranial GCTs.

=Other Diagnostic Studies

Treatment

Management Options of Penial Gland tumors
CSF diversion
  • The optimal surgical strategy to treat acute hydrocephalus in patients with pineal tumors is uncertain.
Surgical resection
  • Some series report long-term survival with surgery alone, even in patients with pineoblastomas.
  • Indeed, for pineoblastomas, gross total surgical resection appears to correlate with improved survival.
  • Patients with symptomatic recurrent pineocytomas should also be considered for surgical resection of the lesion
Radiation
Stereotactic radiosurgery
  • Stereotactic radiosurgery (SRS) is emerging as a useful treatment alternative for pineocytomas, although experience is limited.
  • The precise radiation fields that are defined by MRI or CT-computerized treatment planning minimize damage to the surrounding brain, and the risks of general anesthesia and craniotomy are avoided.
  • SRS is increasingly being used to treat pineal region tumors, either as an additional therapy after conventional treatments or as a primary treatment.
  • Due to the low rate of side effects, IRS may develop into an attractive alternative to microsurgery in de novo diagnosed pineocytomas. In malignant PPTs, IRS may be routinely applied in a multimodality treatment schedule supplementary to conventional irradiation.
Chemotherapy as part of multimodality therapy

References

  1. 1.0 1.1 1.2 Shahinian H, Ra Y (2013). "Fully endoscopic resection of pineal region tumors". J Neurol Surg B Skull Base. 74 (3): 114–7. doi:10.1055/s-0033-1338165. PMC 3712663. PMID 24436899.
  2. Tan HW, Ty A, Goh SG, Wong MC, Hong A, Chuah KL (2004). "Pineal yolk sac tumour with a solid pattern: a case report in a Chinese adult man with Down's syndrome". J Clin Pathol. 57 (8): 882–4. doi:10.1136/jcp.2004.016659. PMC 1770394. PMID 15280413.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Ji J, Gu C, Zhang M, Zhang H, Wang H, Qu Y; et al. (2019). "Pineal region metastasis with intraventricular seeding: A case report and literature review". Medicine (Baltimore). 98 (34): e16652. doi:10.1097/MD.0000000000016652. PMC 6716749 Check |pmc= value (help). PMID 31441839.
  4. 4.0 4.1 4.2 4.3 Ronchi A, Cozzolino I, Montella M, Panarese I, Zito Marino F, Rossetti S; et al. (2019). "Extragonadal germ cell tumors: Not just a matter of location. A review about clinical, molecular and pathological features". Cancer Med. doi:10.1002/cam4.2195. PMID 31568647.
  5. Takami H, Fukuoka K, Fukushima S, Nakamura T, Mukasa A, Saito N; et al. (2019). "Integrated Clinical, Histopathological, and Molecular Data Analysis of 190 Central Nervous System Germ Cell Tumors from the iGCT Consortium". Neuro Oncol. doi:10.1093/neuonc/noz139. PMID 31420671.
  6. 6.0 6.1 6.2 6.3 Fang AS, Meyers SP (2013). "Magnetic resonance imaging of pineal region tumours". Insights Imaging. 4 (3): 369–82. doi:10.1007/s13244-013-0248-6. PMC 3675249. PMID 23640020.
  7. Mufti ST, Jamal A (2012). "Primary intracranial germ cell tumors". Asian J Neurosurg. 7 (4): 197–202. doi:10.4103/1793-5482.106652. PMC 3613642. PMID 23559987.
  8. Al-Hussaini M, Sultan I, Abuirmileh N, Jaradat I, Qaddoumi I (2009). "Pineal gland tumors: experience from the SEER database". J Neurooncol. 94 (3): 351–8. doi:10.1007/s11060-009-9881-9. PMC 2804886. PMID 19373436.
  9. 9.0 9.1 9.2 9.3 9.4 9.5 Fetcko K, Dey M (2018). "Primary Central Nervous System Germ Cell Tumors: A Review and Update". Med Res Arch. 6 (3). doi:10.18103/mra.v6i3.1719. PMC 6157918. PMID 30271875.
  10. 10.0 10.1 Uda H, Uda T, Nakajo K, Tanoue Y, Okuno T, Koh S; et al. (2019). "Adult-Onset Mixed Germ Cell Tumor Composed Mainly of Yolk Sac Tumor Around the Pineal Gland: A Case Report and Review of the Literature". World Neurosurg. 132: 87–92. doi:10.1016/j.wneu.2019.08.079. PMID 31470154.
  11. Fujimaki T, Matsutani M, Funada N, Kirino T, Takakura K, Nakamura O; et al. (1994). "CT and MRI features of intracranial germ cell tumors". J Neurooncol. 19 (3): 217–26. doi:10.1007/bf01053275. PMID 7807172.
  12. Morana G, Alves CA, Tortora D, Finlay JL, Severino M, Nozza P; et al. (2018). "T2*-based MR imaging (gradient echo or susceptibility-weighted imaging) in midline and off-midline intracranial germ cell tumors: a pilot study". Neuroradiology. 60 (1): 89–99. doi:10.1007/s00234-017-1947-3. PMID 29128947.
  13. Davaus T, Gasparetto EL, Carvalho Neto Ad, Jung JE, Bleggi-Torres LF (2007). "Pineal yolk sac tumor: correlation between neuroimaging and pathological findings". Arq Neuropsiquiatr. 65 (2A): 283–5. PMID 17607429.


Template:WikiDoc Sources